Abstract

Background: Cytoreductive surgery (CRS) and Hyperthermic Intraperitoneal Chemotherapy (HIPEC) are complex procedures associated with significant morbidity and mortality. Thyroid dysfunction is increasingly recognized as a potential factor influencing postoperative outcomes.

Objective: This study aimed to evaluate the effect of CRS and HIPEC on thyroid hormone and cortisol levels, and their association with surgical outcomes.

Methods: Four hundred patients undergoing CRS and HIPEC for peritoneal metastases were included. Patients with thyroid or endocrine disorders were excluded. Serum levels of TSH, Free T3, Total T3, Free T4, Total T4, cortisol, and albumin were measured preoperatively, intraoperatively, and on postoperative days 3, 6, and 10. Statistical significance was assessed using the paired Student’s t-test.

Results: Free T3 and Total T3 levels were significantly decreased on the first and sixth postoperative days (p < 0.05). Cortisol levels increased significantly on postoperative days 4, 6, and 10 (p < 0.05), with the highest levels observed in patients with adverse events. TSH levels decreased initially but normalized progressively. Albumin levels dropped significantly during the first week. Free T4 and Total T4 showed no significant changes.

Conclusion: Thyroid dysfunction and cortisol response are common after CRS and HIPEC, with Free T3 levels correlating with shorter ICU and hospital stays, and TSH changes associated with prolonged recovery. Preoperative and perioperative thyroid assessment may optimize surgical outcomes.

Keywords

Chemotherapy,significant morbidity,mortality